Substance withdrawal management

Sound withdrawal management (sometimes known as detoxification) allows a person who is dependent on alcohol or some other drug, to cease their use with safety and some level of comfort. It can involve rest, counselling, good nutrition, vitamins, and at times medications.

A range of public and private services provide withdrawal programs. For a list of services in South Australia visit the Drug and Alcohol Services page.

Aims of withdrawal management

The aim of withdrawal management is to treat the unpleasant and at times life-threatening clinical features of withdrawal, to prevent complications, and to enable the planning of ongoing treatment after the withdrawal process has subsided.

Many drug users, their parents and the general community believe that ending dependence is simply a matter of ceasing use and detoxifying the body. As such, they see withdrawal management as a treatment. For more information, visit the Treatment options page.

Withdrawal management is only the first step but it enables drug users to move towards the next stage of dealing with their alcohol or drug problems. At the least it enables a period of respite from the risks associated with regular drug use. At best it links directly into follow up treatments.

People using alcohol and other drugs have different reasons for wanting to withdraw and will be at different stages in changing their behaviour. Understanding the person’s goals and expectations of withdrawal management will help you advise them appropriately on the best form of intervention for them.

Further information

Call Drug and Alcohol Clinical Advisory Service (DACAS) on 7087 1742 if you are seeking advice in managing drug and/or alcohol affected patients. There is 24-hour, direct telephone access to a specialist drug and alcohol medical officer.

Assessment

Take a comprehensive substance use history, including:

all types of drugs used

duration of use, quantity and frequency of recent use, route of use and time of last use

assessing previous drug treatment attempted

assessing the level of current intoxication and withdrawal

assessing general physical and mental state, including ongoing health problems

Follow-up treatment

Detoxifying the body is not a cure for tolerance and dependence and, without follow-up treatment, the person is likely to relapse and start using alcohol or other drugs again. This is because their brain chemistry has changed in response to the alcohol or other drug being constantly present. Therefore, it is a good idea to try to follow up withdrawal treatment with
counselling, residential rehabilitation, and for some
substances ongoing
medication assisted treatment.

Many patients will want to deal with a range of personal, emotional or relationship problems during the withdrawal episode, but they should be persuaded to defer all this until later. Withdrawal is not the optimal time for working through issues because it is likely to be stressful. Crisis intervention may be needed during withdrawal to ensure adequate accommodation, food or other urgent welfare needs are met. However, it is better to address wider problems as part of ongoing rehabilitation, after the withdrawal attempt.